All posts by Leticia Miranda

Nanyantara Sen is now on birth control pills after she learned the Depo Provera shot put her at a higher risk of stroke because of her family’s history of blood clots. Photo by Leticia Miranda

by Leticia Miranda

Nanyantara Sen was broke and had lost her one connection to affordable birth control when she ended her relationship with her college boyfriend. She was 22 and took up a job working at a film festival making about $14,000 a year.

“I was learning really quickly I couldn’t pay for my rent, do groceries, health insurance and birth control,” said Sen, now 27 and living in Brooklyn. “I was just in triage mode a lot.”

She lived in Lansing, Mich. at the time and went to her local Planned Parenthood to get birth control. The appointment was pretty standard. A clinician took her medical stats, sat her down and asked about her family health history. Then they talked about birth control options. A shot called Depo Provera seemed like the best option. It was affordable. She only had to take it once every three months and they had the shot in stock there at the office. So she took the shot.

Over the course of a few months, Sen started to experience some serious changes in her mood and body. She gained 30 pounds and fell into a deep depression.

“It was like this wave of sadness that fell over me,” she said. “It eventually got so bad my stepmother started calling me everyday she said, ‘I’m really worried about you we think you might be thinking about killing yourself we don’t know if you’re suicidal or not but we’ve never seen you this way. This isn’t you at all.’”

Along with her depression, she felt extremely fatigued which made it difficult to keep a job. She suffered for about two years with the depression and fatigue until she got a job in the city which offered health insurance. By that time, she had completely lost her period. She finally saw an OB/GYN who was horrified that she had taken the shot. Her family’s history of blood clots posed a serious risk to Sen for stroke because the shot can impact blood flow. She also explained to her that she may have trouble getting pregnant because of the shot.

Like many contraceptives, DepoProvera is designed to limit fertility in women who use it as a birth control. But Sen, along with a number of other women, have found the long-term side effects of the drug have not outweighed the benefits. The drug is also disproportionately prescribed to women of color, namely Black and Native women.

“That does suggest that there is a socioeconomic and racial disparity in prescribing practices,” said Dr. Edra Spevack, who wrote a paper published in Integrative Medicine about the long-term side effects of the Depo shot.

Several court cases against Pfizer alleged that the drug led some women to lose severe bone density which caused osteoporosis. A few of those early cases led the Federal Drug Administration to apply a “black box warning” on the shot warning users of the risks of the drug. The National Institute of Health has confirmed these risks stating to users that the longer they use the medication “the more the amount of calcium in your bones may decrease” and the “amount of calcium in your bones may not return to normal even after you stop using medroxyprogesterone injection,” according to its website.

But for many low-income women, the cost of the drug makes it an attractive option. Most other birth control pills can cost about $40 a month. For low-income women, that can be quite expensive. The Depo shot can cost between $35 and $100, but it needs to be taken only every three months.

In some cases, the shot’s risks might outweigh the benefits, said Spevack. Women of color suffer from higher risks of unplanned pregnancies and maternal mortality. So a birth control option that is affordable and doesn’t require taking a pill everyday can be a great benefit.

But for Nana, the drug made a severe impact on her body. Now that she’s educated herself about the drug, she feels more informed and feels like she has more agency over her body. Though she says she’d never use the drug again.

“I think I feel like I have a little more control now because the duration of the drug has been finished,” she said. “And I’ve been learning and reading more about it and that has given me a sense of agency and empowerment.”

At a moment when cries about the end of journalism reach a high pitch, two local tabloid reporters in Philadelphia demonstrate that gumshoe reporting is still alive and more relevant than ever. Wendy Ruderman and Barbara Lake’s “Busted: A Tale of Corruption and Betrayal in the City of Brotherly Love” is a first hand account of two reporters efforts to uncover wrongdoing in the local narcotics unit. Through their work, Ruderman and Laker prove to pessimists that traditional newspaper reporting still has a place in the changing field of journalism.

The opening lines of “Busted” read like a thriller novel. In a short 242 pages, authors Wendy Ruderman and Barbara Laker, two intrepid investigative reporters with the Philadelphia Daily News, bring readers into the darkest corners of the city where the line blurs between crime and crime fighting. Immediately Ruderman and Lake drop us into the life of Ventura “Benny” Martinez, a former confidential informant for a corrupt Philadelphia narcotics officer who becomes a major source, at a point where the fear for his own life drives him to seek help from these two reporters. “His pudgy, sweaty fingers gripped the handle of a .44 Ruger equipped with an infrared laser to illuminate whoever would be coming for him,” they write. Through the story of uncovering a trail of police misconduct, Ruderman and Laker shed light on a newspaper industry at the brink of collapse, the balance between motherhood and reporting and the stubborn brotherhood that kept corrupt police protected from justice.

In “Busted”, Ruderman and Laker become characters in their own story. Laker, a “sweetheart” who was “oblivious to her ability to make men’s heads turn,” and Ruderman, a “crass” and “pint-size” reporter, become our heroines. They take us into the dusty bowels of the city’s court records where they shuffled through hundreds of search warrants with Laker in “knee high leather boots.” We walk with them from home to home looking for past informants, at one point Laker retelling her account of how she was slapped by Tiffany, another confidential informant. Multiple times through the book, we share their moments of giddiness and excitement as one tip leads to another sordid detail in this network of crooked cops terrorizing the city.

The most novel moments come during the authors’ honest portraits of how they struggled to balance motherhood, dating and reporting. These points in the book remind readers that reporters are not machines, but people who share some of the same insecurities and fears as others. Ruderman describes her son’s jabs at his mom over his frustration that she barely was home. At one point when Karl, Ruderman’s husband, went to the grocery and left Ruderman with her two boys, one asked, “Mom, are you babysitting us?” Laker’s story about how her marriage crumbled before she began her reporting that would lead to a Pulitzer Prize adds depth and sincerity to her character as a relentless reporter.

Their story is as much about their pursuit to root out police who terrorize the community they are charged to protect as the role that “traditional” journalism continues to play in our society. This sub-plot put their reporting in context with the times. As the two reporters pursued a Pulitzer Prize winning story, the edifice of journalism crumbled around them. But the story doesn’t end on a pessimistic note. Instead, it will leave readers with a taste of Ruderman and Lake’s infectious courage and how that courageous reporting will never die, but continue to reinvent itself through new institutions.

When Richard Kelso was diagnosed with HIV in 1987, he was devastated. In the late 1980s, scientists and physicians were still trying to understand the virus. The available medications they used to treat HIV were often toxic and untested.

But Kelso’s devastation quickly gave way to hope that he could live with this illness. The clinician at the Chelsea Health Clinic in New York, where he was diagnosed, gave him a stack of pamphlets about HIV as well as support groups he could attend.

“Even though I was frightened of the prospects, she made it seem like there was a possibility that it was not a death sentence,” said Kelso, 71, sitting on a piano bench in his Chelsea apartment. “There was something I could do that could be helpful and I didn’t have to just go home and wait to die.”

For the first five years after he was diagnosed, Kelso treated himself with a regiment of Chinese medicines and herbs to boost his immune system. It was the beginning of a series of experiments in staving off the virus. Eventually he began taking pharmaceutical drugs to manage his illness. He says he has never been hospitalized because of HIV.

“The medications have been miraculous,” said Kelso. “As somebody who is aging with HIV, the biggest hurdle is to just deal with the apprehension about death and my health from day to day.

Richard Kelso,71, has lived with HIV for 30 years. He says becoming an expert on your own health is a survival strategy. Photo credit: Leticia Miranda

By the mid-1990s, treatment for HIV drastically improved which meant that people like Kelso had the chance to live a longer life. Now he is one of a growing number of people who are living longer with HIV as treatments have become more effective. But even with these advances, patients with HIV and their physicians have a more complex challenge ahead of them as they try to treat HIV along with the typical illnesses that come with aging.

Many people aging with HIV face what clinicians call “multi-morbidity,” which means the patient has multiple incurable health issues that are treatable. In Kelso’s case he has to be treated for HIV as well as cholesterol, which is a result of aging not the virus or medication. Traditionally, doctors are trained to treat HIV apart from other health conditions. In geriatric medicine, doctors are trained to work with patients older than 65 with multiple health issues but may not know how to treat HIV along with those other illnesses.

This kind of treatment is essential to people aging with HIV. They are at a higher risk for diabetes, cardiovascular disease, early frailty and kidney failure. The medicine to treat these could aggravate the HIV and the HIV treatment could have a damaging affect on their other health conditions.

“We call it going from the silo of treating HIV and now going to treating the whole person at once,” said Steve Karpiak, senior director for research and evaluation with ACRIA, an HIV research organization. “The question is what is the primary disease that has to be managed? The reality is they all have to be. It’s a balancing act and it’s best done through a team approach with the patient.”

But health care is not the only issue confronting some people aging with HIV. They are often more likely to have weaker social networks than people who are not infected with HIV. Many of them are isolated from their families because of their illness or sexuality. The networks they do have are mostly other HIV-infected people who may not be able to provide the kind of long-term care they will need.

“Some live alone and don’t have a partner,” said Bill Mendez, a case manager at Services and Advocacy for GLBT Elders, who runs a support group for people aging with HIV. “There’s a lot of anger and a lot of resentment towards their family or siblings. They don’t hear from them. They don’t speak to them. They come here for support.”

Kelso has over 30 years of being his own advocate and has created a healthy and full life for himself. Over the years he has had to become an expert on his own illness.

“We treat our doctors as consultants not as a god who dispenses medicine,” said Kelso about the SAGE support group. “You have to take control and be your own best advisor. Don’t take what the doctor says as a mandate that you have to adhere to because sometimes they don’t know. As new medications come along they dispense them but they don’t know what the long-term effects are. It’s up to you to sort of keep on top of that.”

Middle Church members clap to music during Sunday’s worship. The Church has over 800 members, who are various races, sexualities and genders. Photo credit: Leticia Miranda.

The topic of religion and reproductive rights has taken a new turn with a recently launched national campaign to talk about controversial reproductive health issues directly from the pulpit.

The campaign called, “It’s Time,” plans to equip faith leaders with new curriculum, sermons and engagement tips available this March to “change the conversation on faith and reproductive choice,” according to the Religious Coalition for Reproductive Choice’s website, an interfaith coalition based in Washington, DC. But even with its novel goals, the campaign’s mainly liberal church base struggles to meet the needs of its members who look outside church for guidance around their reproductive health.

Selima Jumarali, 28, a member of the Middle Church in the East Village, Manhattan, which is a protestant-based organization with a social justice framework, said that for her spirituality and faith are not the strongest influences over her reproductive health decisions.

“For me it’s more my social justice that guides my reproductive decisions than my faith,” she said. “It’s more about investigating myself as a woman and the choices I have and the power I have over my body that would lead me to decisions about my reproductive health rather than what a text says or what a religious leader tells me.”

Jumarali said she attends Middle Church for a spiritual network and a way to learn about social justice efforts. She has more personal connections outside of church where she might discuss issues of reproductive health.

Middle Church member Clara Ibarra said, she thinks that the church is a supportive place to talk generally about reproductive health decisions, but likewise would choose to seek counseling elsewhere if she faced a serious life decision like whether or not to terminate a pregnancy.

“Independently of my faith, I try not to put myself in that situation so I take measures to make sure that doesn’t happen,” said Ibarra, who has attended Middle Church since 2008. “I don’t know if it’s religious. I think it’s more like who I am. I think if you get to that place this would be an open community to support you in that process whatever your decision is.”

This gap between a progressive church’s social justice mission and its actual practice meeting the needs of women is where Rev. Kelli Clement, the executive director of the Minnesota Religious Coalition for Reproductive Choice and a community Minister in Minneapolis, Minnesota, hopes to fill through the campaign’s curriculum and their own organization’s training tools.

“I know tons of people who are faithful and pro-choice but can’t connect those two things,” she said. “When we are able to connect those two things, our spiritual journey and reproductive lives open up. We understand ourselves more holistically.”

In February, Minneosta Religious Coalition for Reproductive Justice, the state affiliate to the national organization, launched the first of several new trainings for clergy across the state on how to support their congregants through reproductive loss. That includes everything from abortion to miscarriage to sexual trauma. She herself benefitted from a Religious Coalition for Reproductive Justice training when two separate women called her office two years ago after feeling triggered by conservative attacks on women who become pregnant through rape and choose abortion.

“They knew they wanted to talk about their experience, but not in a therapeutic setting,” said Clement. “They wanted to help make sense of their experience and triggers in light of their faith. It felt wonderful to be able to have this delicate conversation and be a part of it.”

Jacqueline Lewis Senior Minister at Middle Church said that, like Clement, members come to her for spiritual guidance after other reproductive losses like a miscarriage. She rarely hears from congregants who chose to terminate a pregnancy in part because of their fear of judgment, she said.

“I don’t think anyone does it lightly so there’s a space right there for compassion and for prayer and acknowledging the toughness of the decision,” said Lewis. “What should happen from the church is a blessing and prayers for peace. The church’s job is to comfort those who mourn and help people make the best ethical decisions for their life circumstances.”

Not all faith leaders are as comfortable talking about sensitive topics like abortion in a sermon let alone as a confidant to one of their members. Some of the campaign’s advocates say that’s where these new tools can help clergy support their members who do look to their church institutions for guidance.

“As people of faith, we have been many times so reluctant to be present in the wholeness of people who have sexuality and in their brokenness when they are dealing with challenging issues,” said Clement. “That’s why as people of faith it’s important for us to be present with people in their totality.”

Susan Davis, 57, has attended Middle Church since 2004. She says that she appreciates the church's social justice lens to faith. Photo by Leticia Miranda

Middle Church member Susan Davis,57, discusses her journey in understanding reproductive rights.

Christina Henriques, a freshman accounting major at St. John’s University, said this program will give her the professional experience she needs to succeed in an accounting career. Photo credit: Leticia Miranda

Even before the ice thaws and the cold front passes, New Yorkers are gearing up for the impending tax season. Many will turn to online filing services or a trusted tax firm they have used for the last 20 years.

Others will turn to a growing set of university students trained to prepare taxes for the country’s most needy families and their new online system aimed to reach a greater number of taxpayers.

St. John’s University in Jamaica, Queens today launched an online-based program intended to make it easier for local low- and middle-income people to file their taxes. The city’s program, called Virtual Volunteer Income Tax Assistance, partners with Food Bank NYC sites across the city to reach potential taxpayer clients. Families who made less than $50,000 and individuals who made less than $20,000 are eligible for the program. Those sites scan their tax documents into a secure web server, which is then fed to the virtual center based at St. John’s. At that point, the student volunteers process their tax information. In turn, students get hands-on accounting experience in taxes.

Traditionally the program, run by the Internal Revenue Service, depends on in-person and paper-based tax preparation. In the past, students met face-to-face with taxpayers at intake sites, which burdened the program with high costs and left some clients waiting two hours or more, according to the City’s Department of Consumer Affairs. The new online-based system is expected to be more cost-effective and efficient.

“I’m thrilled,” said Nina Dorata, a professor in the Department of Accounting and Taxation at St. John’s University. “I expect the productivity of the students in this virtual setting will just skyrocket. We’re looking forward to a very productive tax season.”

Since 2009, professors like Dorata, in partnership with Food Bank NYC, have funneled nearly 500 student volunteers into the program at the university. In that time, St. John’s University students have prepared taxes for close to 4,000 low and middle-income families and individuals in New York. Since the program began in 2002, it has filed about 400,000 tax returns on behalf of low-income New Yorkers resulting in $700 million in tax refunds, according to the Department of Consumer Affairs.

“Those kinds of refundable tax credits can mean the difference between putting food on the table and not putting food on the table,” said Dorata.

In New York, Dorata’s remarks are hardly an exaggeration. Roughly 1.6 million New Yorkers live below the poverty line, according to the Census. About 1.4 million residents — mainly women, children, seniors, the working poor and people with disabilities — rely on soup kitchens and food pantries to eat, according to statistics from Food Bank NYC. The group reports low-income families can earn up to $7,649 in tax refunds.
“I worked with 35 clients last year,” said Garvey Jean, a sophomore in the accounting department and a second-year volunteer with the program. “That was 35 households I helped to get a tax refund who really needed it. It’s a really great feeling.”

“There’s pressure, but not too much pressure so you’re not freaking out about the job,” said Cristina Henriques, a sophomore in accounting and first-year volunteer who wants professional experience in taxes. “The supervisors tell us how to do everything step-by-step. They make it really simple for us.”
The students, mainly accounting majors, go through rigorous training before preparing taxes. They are required to pass the Lincoln Learn exam administered by the Internal Revenue Service and complete tax training during the university’s winter intersession.

“Right now there really are no borders on this program,” said Jean. “We’re not just limited to Queens and Nassau County. We’re servicing the Bronx, Yonkers, Brooklyn. This virtual site allows us to help a lot more people.”

The world remembers several iconic images from the tragedy that struck the World Trade Center on September 11. The planes spearing through the towers at a rapid speed. The billowing fire. The towers crumbling to the ground. Maria Segaline remembers the smell.

“As soon as you got out of the train, you could smell it,” said Segaline, a 45 year-old Bolivian immigrant from Queens who worked at the World Trade Center and returned to work soon after the attacks. “We realized that it was the smell of burning. It wasn’t a nice smell, it was a horrible smell.”

After working there for almost a year, Segaline started to get sick. “I couldn’t talk because my voice was hoarse and I had the flu,” she said. “My throat swelled.”

She didn’t think it was the toxic air that lingered in the wake of that tragic day. She continued to work 12 or 16 hour workdays and medicated herself only with hot tea at home. Because she worked alone, her co-workers never saw her suffer from a high fever or take a break to vomit at work. She said she never went to see a doctor because she needed to work.

Segaline finally went to see a doctor in 2005 to get treatment under the World Trade Center Health Program available through the Bellevue Hospital Center in Midtown Manhattan, which offers medical and psychological treatment to responders after the attacks and people who worked or lived in the area. As part of her treatment, she got involved in an art therapy program for survivors.

“In 2005, I was another person because the whole time I was fighting for my body. I was so sick. I don’t like to remember it,” she said.

At the time she was also suffering from depression. “But the program helped me change my ideas and thoughts,” she said. “I’m now more happy.”

Segaline is one of about 14 participants in the World Trade Center Health Program’s art therapy program who featured their artwork in an exhibition at the Bellevue Hospital Center. The exhibition features 35 pieces of artwork by people who lived and worked in Lower Manhattan or helped in the September 11 cleanup and are now suffering from medical and emotional health problems. Their art offers them a creative release for the trauma they experienced on that horrific day and the health problems they continue to battle now.

Maria Segaline, 45, of Queens, creates dolls based off of Aymara, an indigenous community in Bolivia. Photo credit: Leticia Miranda.

“Before I could work normally,” said Segaline. She paused to let out a quiet wet cough. “Now I am more limited but the art has helped me a lot.” She has been a participant in the program for eight years where she makes small dolls of Aymara, an Indigenous community in Bolivia. She hopes to craft dolls inspired by Cherokee natives.

Each week the participants gather for about two hours to work on their art pieces. Sometimes they have directives like reminiscence, homeland, the seasons or a theme like self care, coping tools. But mostly it’s a free two hours to be creative and express their inner thoughts through their art.

“Art is therapeutic for people who have this form of trauma,” said Irene Rosner David, Director of Therapeutic Arts at the Bellevue Hospital Center, who has lead the program since it’s beginning in 2005. “It can help them move in their recovery process towards a more adaptive way of life by acknowledging the past and moving forward.”

Rosner David said the title of this year’s exhibition was chosen to capture the program participants’ evolution towards healing from that traumatic day.
“There has been gradual more of the uplifting elements,” she said. “More intense color, more elements of nature. It’s not like there aren’t any elements that feature traumatic experiences, but we’re also seeing messages dealing with the here and now and moving on.

“It gets me up in the morning,” she said. Before the program, Segaline was extremely depressed. She said she didn’t want to talk to anyone. She was afraid and wanted to stay inside her house. She still can’t work because she fatigues quickly and has trouble breathing but art therapy has given her an outlet to pass her long days at home.

“Before I didn’t want to live,” said Segaline. “Now I wake up in the morning. I clean my house. I take my medicine. I want to live.”

The exhibition will be open to visitors in the hospital center’s lobby during weekdays until September 18.

Thanu Yakupitiyage, 27, is a queer immigrant living in Brooklyn, New York on a work visa and says she supports political candidates based on actions not identity. Photo by Leticia Miranda

Just after the Supreme Court released their decision to overturn the Defense of Marriage Act, Christine Quinn gathered supporters outside of the Stonewall Inn. The case’s lead plaintiff, Edie Windsor, made an appearance and announced her proud support for Quinn. It was a symbolic moment where Quinn placed herself as the second in line to make gay and lesbian history as the next mayoral hopeful.

This moment was not her first and would not be her last even as her mayoral campaign gave way to Bill de Blasio as the leading Democratic candidate. Over the last two months Quinn has made bold attempts to court the LGBT vote by framing herself as the first lesbian woman mayor in New York City history and a symbol for gay rights nationally. Indeed her election would be historic, but her campaign strategy to pander to the LGBT vote as a bright symbol of progress alienated some queer people of color who say that policies and actions matter more than identity. Now on primary day, Quinn’s campaigning is languishing in the third place with hopes of at least participating in a run off fading fast.

“There was so much excitement about Christine Quinn because New York has never had a female mayor let alone a gay mayor,” said Thanu Yakupitiyage, a 27 year-old queer Sri Lankan activist who lives in Brooklyn, New York on a work visa. “At the same time, I don’t think it’s enough to vote for Christine Quinn because she’s a lesbian woman.”

Yakupitiyage has been closely following the mayoral campaigns though she is ineligible to vote because of her immigration status. She is especially critical of Quinn’s track record on paid sick leave, hospital closures and raising the minimum wage.

Two years ago, Quinn refused to let a paid sick leave bill come to a vote at the City Council in an attempt to cater to New York’s business community. When the Council finally voted and passed the bill, Quinn marked it a victory for New York while glossing over her attempts to stop the bill from a vote. But most importantly, Yakupitiyage is critical of Quinn’s support for Ray Kelly and her failure to vote against the Stop and Frisk bill, a part of the Community Safety Act which would prohibit police officers from profiling people based on race, gender, age or homelessness.

For some queer voters of color, Quinn’s vote on the Community Safety Act showed them that she is an unsurprising moderate candidate who manages to tap into her identity as a lesbian while also failing to concretely address the issues facing those communities.

“In some ways she challenges the gender norms,” said Chelsea Johnson-Long, a program coordinator at the Audre Lorde Project, a LGBTQ rights advocacy organization based in New York City that has been a fierce opponent of the city’s Stop-and-Frisk policy.

“But as a black lesbian who comes from a working class community, I have bigger concerns than getting married.” Johnson-Long said every time she walks in the subway with her girlfriend, police stop her to check her bag.

“I would be excited to see her address the intersections of race and sexuality and how that affects New Yorkers,” said Johnson-Long who has worked with trans and queer communities of color in New York for five years. For others, Quinn’s identity platform is hardly a beacon of hope. Instead it confirms their cynicism about the possibility of electoral politics to bring equality.

“It would be unprecedented to have people of certain identities in high offices,” said Julian Padilla, a 27 year-old queer Latino in Bed Stuy, Brooklyn who casted his vote today for Bill Di Blasio. “But if they’re going to just use that to continue the disenfranchisement of those communities, we have to rethink electoral politics as the solution for social justice.”

Padilla learned about Quinn’s campaign mostly through Facebook where his friends showed their disapproval of the candidate after she failed to vote to ban profiling as part of the Community Safety Act. Quinn only voted for the provision of the Act that established an inspector general.

“She put herself at odds with communities of color and LGBT communities of color,” said Padilla. “ I would love for the city to have a lesbian mayor but before I want a lesbian mayor I want a mayor who is actually going to back policies and bills that support lesbians in general.”